Determine fluids needed for adequate patient hydration by calculating the sum of the following: emergency needs for resuscitation; restoration of hydration; maintenance requirements; and ongoing losses.

Measure fluid losses, for example in urine and faeces. Calculate fluid restoration, resuscitation and maintenance requirements, using formulas based on body weight available in references such as "The Merck Manuals." Subtract any fluids the patient ingests from IV fluid needs.

Heart rate may increase, and body weight, gum moisture and skin turgor, the resiliency of skin after it is pinched, may decrease. Over-hydration, caused by administration of excess IV fluids, may cause swelling of tissue, increased respiratory rate and abnormal lung sounds.

Increase or decrease IV fluid administration rate as need is indicated by these parameters.

Monitor central venous pressure to avoid dehydration and over-hydration. Central venous pressure is measured with a manometer attached to a catheter placed in a vein near the heart. It may increase during over-hydration and decrease with dehydration.

For example, patients may need calcium and potassium supplementation in pancreatitis cases, and blood tests guide fluid therapy in addressing these needs. A clinician may need to add electrolytes to IV fluids.

Tip

Increased body temperature will increase IV fluid needs.

Warning

Professionals should direct IV fluid monitoring as errors can lead to serious injury or death.

Tips and warnings

Increased body temperature will increase IV fluid needs.

Professionals should direct IV fluid monitoring as errors can lead to serious injury or death.